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Price often dictates which fertility treatment couples receive

Posted August 10, 2009
Updated October 12, 2011

— Less expensive treatments for infertility are more prone to produce multiple births than pricier options, according to experts, but many insurance plans don't cover the more expensive treatments.

For example, physicians can control how many children a pregnancy produces through the use of in-vitro fertilization, or IVF.

In-vitro fertilization, multiple births Multiple births common in cheaper fertility treatments

"You see those higher-order (multiple births) – the ones that are more than twins – often in the group that doesn't do IVF," said Dr. Susannah Copland, of the Duke Fertility Clinic.

The cost of an average IVF treatment is about $13,000, and most insurance plans in North Carolina don't cover it. The least expensive treatment, which uses pills to boost fertility, starts at less than $1,000.

"We don't actually get a demand from employers in the marketplace to provide that coverage. It's quite expensive," said Dr. Genie Komives, senior medical director and vice president at Blue Cross Blue Shield of North Carolina.

Fourteen states require insurance companies to provide coverage for fertility treatments. North Carolina doesn't have such a mandate, but Komives said Blue Cross, the state's largest insurer, does offer some coverage.

"We stop short of artificial insemination and what they call artificial reproductive technology," she said.

That technology includes IVF.

Some experts argue that covering IVF could be less expensive for insurance companies in the long run by reducing the cost of caring for multiple babies, which often require longer hospital stays.

Copland said the decision about which type of treatment to seek often comes down to price. The expense sometimes means the people who are least likely to afford having two, three or more babies could be the most likely to have them, she said.

"I wish that more of my patients had the ability to choose (a treatment) on a level playing field," she said.

Kate Gosselin, one of the stars of the reality television show "Jon and Kate Plus 8," used a fertility treatment involving shots, which costs about $3,000. She and her husband wanted to have one more child after having twins, but they wound up with sextuplets.

Meanwhile, Wendy Fox and her husband spent almost $30,000 on three rounds of IVF before finally having twin girls two years ago.

"You do what you have to do to have children," Fox said. "It's been wonderful and fulfilling in a way that you would never know it could be unless you were a mom."


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  • vrigg45071 Aug 13, 2009

    mom2two, do you think you can just run out to your local "Adoption R' Us" and pick up a child or two? Did you read any of these comments? How do you know what's in someone's heart. People try for years and spend thousands to have a child...I am certainly pro-adoption but it's not viable for everyone. The insurance system is backwards. I liken it to the time when insurance wouldn't pay for a forty dollar chiropractic visit, but it would pay thousands for back surgery.

    People who seek fertility treatments are screened carefully. Their children are WANTED children. I think you are extremely short-sighted, but I am so happy that you didn't have to pay for treatments to have your beautiful children.

  • MisunderstoodMind Aug 12, 2009

    I'm so pleased I was able to alleviate your confusion :-) Interesting though that a person who "doesn't care" about the topic "had" so very much to contribute.

  • shortcake53 Aug 12, 2009

    Dear Misunderstood, i couldnt care less . Got it?

  • MisunderstoodMind Aug 12, 2009

    Dear, dear shortcake, let me attempt to put this in simpler terms.

    The $3000 procedure (pills, shots, etc.), allows the doctor NO control over how many eggs will be released within a cycle. For example, if a woman uses a regime of Ganirelix with Menopur, she could develop 5-10 mature follicles (eggs). when the ovaries release said eggs, each one has the chance to become fertilized and/or split. The Gosselin's experienced this very situation.

    If the aforementioned scenario is coupled with $14,000 IVF, the physician would only place 2-3 eggs back into the uterus thereby limiting the chance of multiples. These eggs could split, but a fewer amount of eggs results in less babies.

    Most folks can get $3000 together easier than $14,000. The $3000 folks have more multiples.

    To answer your question, "Yes, I got it." Matter of fact, the only person that "misunderstood" was you. Hopefully, by "simplifying" the general concept I have lessened the potential for future confusion. Got it now???

  • shortcake53 Aug 12, 2009

    Misunderstood, i know how you got your name. I have undergone these treatments myself, so no need for you to describe whats involved. I now have sons and grandsons. My point is, things seem backwards that the patients who can only afford the less expensive route end up with more than those who could afford higher cost treatments and result with only one. Got it now?

  • CCbabies Aug 12, 2009

    The inability to have a child, when desirous of one, is one of the most difficult life issues women endure. Whether or not to conceive spontaneously is no longer an option, and not a choice, for many. For over two- thirds, infertility is the most stressful issue faced up to that point in their lives. Costs for infertility diagnosis and treatment add to the stress. Fourteen states mandate infertility coverage. In those states couples are less desperate to be overly aggressive with numbers of embryos transferred back into their bodies at the time of in-vitro fertilization, thus lowering the risk of twins, triplets and more. This lowers the overall healthcare costs associated with such maladies as preterm labor, gestational diabetes, and neonatal care for preterm fetuses. As mentioned on the WRAL broadcast, insurance carriers, including BCBS fail to cover medicated cycles that involve husband insemination, despite the fact that insemination increase pregnancy rates two fold, thus savi

  • MisunderstoodMind Aug 12, 2009

    shortcake53...shortcake53??? The less expensive treatments (shots, IUI, pills) typically run about $3000. What these do is "hyperstimulate" the ovaries to produce more eggs. When this occurs, multiple eggs are released thereby significantly increasing the likelihood of multiples. When an IVF cycle is used in conjunction with medication, the eggs are retrieved, fertilized, and put back in the womb. Therefore, the less expensive treatment is much more likely to produce multiples that the more costly IVF. Any questions... Any questions???

  • shortcake53 Aug 11, 2009

    So if I understand correctly, those who can only afford less expensive treatment may end up with the most kids?? How does that make sense?? How are they going to afford the kids if they cant afford pricier treatments? Anyone,.... anyone???

  • MisunderstoodMind Aug 11, 2009

    Following your logic Mom2two, I don't want my insurance paying for your kids. If they break an arm, I say splint it at home and keep my insurance rates down. As for those cancer treatments, lets keep 'em to a minimum. If by chance you develop a "terminal" condition, I don't want to pay for any of it! Your "illness" can cause detriment to my rates!

    Now, doesn't that sound just ridiculous? Yup, it sure does.

    Infertility is a disease. Yes, there are multiple causes for this disease, but the vast majority are treatable. Matter of fact, when physicians are "allowed" to properly manage any condition, patients benefit across the board.

    One more thing... I have growing concern over this whole "my insurance" mentality. Insurance companies thrive on their ability to keep each person separate from another. Why fight amongst ourselves thereby increasing corporate control? If instead it was "our" insurance and "we" want coverage none of this would be an issue.

    Infertility is NOT a choice!

  • vrigg45071 Aug 11, 2009

    Oh, it's just simple to run out and adopt a child! Having children is a choice and everyone has a right to decide what kind of family they would like to have. People who choose the expense of IVF are making a choice to have a medical procedure that will allow them to have children. It isn't easy, nor is it done on a whim. It is tough! Medical procedures of this kind should be covered by insurance.